Medicare Made $11.6B in Improper Payments in 2002, CMS Says
Medicare made an estimated $11.6 billion in improper payments in 2002, according to an annual report released by CMS on Friday, the AP/New York Post reports. According to the report, the rate of Medicare fraud and payments for claims that were medically unnecessary, inadequately documented or improperly coded was 5.8% last year, a decrease from 6.3% in 2001 (AP/New York Post, 11/15). HHS last year shifted responsibility for the report from the department Office of Inspector General to CMS, which paid AdvanceMed $5 million to produce the report.
Results Questioned
Sen. Chuck Grassley (R-Iowa), in a letter to acting HHS Inspector General Dara Corrigan, questioned the results of the report, which he said underestimates the problem of improper Medicare overpayments and is "not statistically valid." Grassley said that the CMS adjusted the results of the report to avoid the appearance of an increase in improper Medicare payments. "It appears that the 'unadjusted' error rate of close to 10% was too high for the CMS," Grassley wrote in the letter. Leslie Norwalk, acting CMS deputy administrator, said that CMS adjusted the rate of improper Medicare payments in the report from about 10%, or $20 billion, to exclude about 6,000 claims in which health care providers submitted no information (AP/Richmond Times-Dispatch, 11/15).
